Meet Dr Vladimir Milovic FRACS (Plast.)

Plastic & Cosmetic Surgeon - Reconstructive Microsurgery

"There is no pressure - nor should there ever be - to have cosmetic surgery at my practice. Cosmetic surgery is not "must have" surgery. It is a choice and therefore you should be given time to think about it, to take educational material away to read, have a written estimate of surgical fees, and think about the surgery including its risks and complications. You have the time to do your homework. If you ever feel pressured into a procedure at any doctor's office...leave." - Dr Milovic

Why did I decide to become a Plastic and Cosmetic Surgeon?

I remember this moment clearly. It was during my surgical training and I was scrubbed in theatre with a vascular surgeon. My future mentor was in the next theatre and was about to perform a re-attachment of an amputated hand. It was late at night and he needed an extra surgical assistant. Being nearby, he asked me to join him in theatre. I was surprised at first, because I didn’t know much about plastic surgery yet, let alone microsurgery! I also thought that Plastic Surgeons mostly performed cosmetic surgery, such as facelifts, breast augmentations and other cosmetic procedures, quite the opposite of what some people think plastic surgeons do in Australia (i.e. there is a misleading presumption in Australia that plastic surgeons only perform reconstructive surgery).

The surgery was a 14 hour microsurgical procedure, and to say that I was impressed would be an understatement! My whole career felt like it had just opened up. It was a long night, yet I loved and absorbed every second of it! The high level of skill, ability, knowledge and creativity that was demonstrated in this case by my future mentor fascinated me. I remember thinking…plastic surgery is what I want to do, and this is where I will specialise.

Two months later, I started my training in plastic, reconstructive and cosmetic surgery. It is now 20 years on, and whether I am doing a microsurgical case or facelift, I still love doing what I do. It is where art meets medicine and medicine meets artistic form. Nothing pleases me more than when I see a patient who has recovered from their surgery and is happy with the work that I have performed for them. To witness an improvement in a patient’s confidence and self esteem following surgery is a great feeling.

I have to say that I was very fortunate to learn from some of the best Plastic, Reconstructive and Cosmetic surgeons in the world. And it was far from easy. It took many years of study, determination, experience, passing oral and written exams in Europe, and then again, in Australia in English (1 of 7 languages that I have learnt).

I learned very early on that in plastic surgery – and this particularly applies to cosmetic surgery where this surgery is not “I must have” surgery but rather “I want” – that knowledge, training, clinical judgement and experience in this specialty is fundamental to achieving the best results. From my experience, I can say that there is rarely a textbook answer to a given problem. Every patient must have their chosen treatment personalised for them, and that requires a high level of clinical skill, training and judgement as well as consultation with the patient, that is, what it is that they want to achieve and further, whether the result is achievable or realistic given the person’s anatomy, health and wellbeing. This is why surgery, in my view, should not be based purely on price. Detailed consultations with a specialist plastic and cosmetic surgeon prior to surgery, is an important step in the process.

I have also learned that it is not the instrument or technology used in plastic and cosmetic surgery that is everything – what matters most, is who is using it i.e. their training and qualifications. It is often assumed that a doctor performing surgery in Australia is qualified to do so. Unfortunately, this is a misconception. Doctors without formal specialist surgical qualifications (which involve further years of extensive of training and education beyond the basic medical degree MBBS), are allowed to perform surgery in Australia. To add to the confusion, they are allowed to call themselves “surgeons” when they are not specialists.

My Surgical qualifications explained

I am a Fellow of the Royal Australasian Society of Plastic Surgeons (FRACS) in the specialty of Plastic Surgery. Plastic Surgery is a general term that covers reconstructive surgery and cosmetic surgery. Cosmetic surgery developed from reconstructive surgery.

Therefore, I am able to use the title “Specialist Plastic Surgeon”, “Specialist Plastic & Cosmetic Surgeon” or “Specialist Plastic, Reconstructive & Cosmetic Surgeon”. However, I choose to go by the colloquial title “Plastic & Cosmetic Surgeon”.

The Royal Australasian College of Surgeons (RACS) is the only college that is recognised by the Commonwealth government (via the Australian Medical Council) to train surgeons. Regardless of any other claims in the public domain, the RACS is the ONLY accredited training college for surgeons in Australia.

Therefore, the letters FRACS are important acronyms to remember – it means that a surgeon has completed a specialist surgical pathway and achieved formal qualifications in surgery. The letters (Plast.) after FRACS means that the specialist has specialised in plastic, reconstructive and cosmetic surgery, one of the 9 surgical specialities formally assessed by the RACS. These letters take 8-10 years to earn through detailed training and rigorous assessment. All Specialist Plastic Surgeons were selected to undergo extensive medical education and training to become accredited with the title Specialist. The surgical specialist pathway includes a minimum of 12 years medical and surgical education, with at least 5 years of specialist postgraduate training.

As stated above, there are 9 surgical specialties for doctors to choose from once they have been accepted by the RACS to train as a surgeon: General Surgery, Orthopaedic, Plastic & Reconstructive Surgery, Urology, Cardiothoracic, Head and Neck (Otolaryngology), Paediatric Surgery, Vascular Surgery, Neurosurgery. My speciality is Plastic, Reconstructive and Cosmetic Surgery. Click here to read more about the surgical pathway in Australia.

Why choose a Specialist Plastic Surgeon?

Currently in Australia, it is legal for any doctor with a basic medical degree to perform surgery, including cosmetic surgery. Specialist Plastic Surgeons, on the other hand, have extensive surgical education and training including a minimum of 12 years medical and surgical education, with at least 5 years of specialist postgraduate training. All surgical procedures carry risk, but you can reduce the chance of risk and complication by consulting a Specialist Plastic Surgeon who is trained, qualified and accredited to perform cosmetic and reconstructive surgery.

Some doctors and surgeons have made the decision to leave their specialty or GP practice and start performing cosmetic surgery. Their training in plastic surgery (including cosmetic surgery) therefore will not have been formally assessed according the recognised Australian and international standards in plastic surgery.

Before undergoing any surgery, you can easily check your surgeon’s registration, including training and qualifications, on the AHPRA website. You can click here to see my registration. You will see that it is specific – I am registered as a specialist to practice only in plastic surgery. If it’s not clear, ask the surgeon about their training and qualifications or check whether they are members of the Australian Society of Plastic Surgeons (ASPS).

The RACS Pledge

By becoming a Fellow of the RACS, I made the following pledge at my admission:

I pledge to always act in the best interests of my patients, respecting their autonomy and rights.

I undertake to improve my knowledge and skills, evaluate, and reflect on my performance.

I agree to continue learning and teaching for the benefit of my patients, my trainees and my community.

I will be respectful of my colleagues, and readily offer them my assistance and support.

I will abide by the Code of Conduct of this College, and will never allow considerations of financial reward, career advancement, or reputation to compromise my judgement or the care I provide.

I accept the responsibility a fully qualified and recognised surgeon by being a FRACS.

Member of the Australian Society of Plastic Surgeons (ASPS)

As a Plastic & Cosmetic Surgeon with 20 years of training and experience, I am also a Member of the Australian Society of Plastic Surgeons (ASPS). Membership criteria are stringent. The ASPS isthe peak body for Specialist Plastic Surgeons (both reconstructive and cosmetic). The main role of the ASPS is to protect the integrity of plastic surgery as a specialty. Our mission is to provide the highest quality Plastic Surgery care to all Australians by:

Administering the AMC accredited Surgical Education and Training (SET) Program for all Specialist Plastic Surgeons

Upholding ethical and professional standards

Promoting public education about reconstructive and cosmetic plastic surgery procedures

The ASPS Code of Practice provides specific guidance on the professional ethics and behaviour required of members of our Society. It reflects the professional standards expected of Specialist Plastic Surgeons by ASPS and the communities we serve.

As a medical practitioner, I have taken the Hippocratic Oath. The following excerpt is, I believe, particularly important when it comes to cosmetic surgery:

“The physician must … have two special objects in view with regard to disease, namely, to do good or to do no harm”

~ Hippocratic Oath, Epidemics (book 1, sect 11)

This ethical maxim requires a doctor to consider the possible harm that any medical intervention may do. I strongly believe in this fundamental ethical principle, and have a strong ethical stance when it comes to my specialist practice.